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adhd medication prescription uk - click through the next document - Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There are few data regarding how exposure over time may affect a fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication for adhd and anxiety must weigh the benefits of taking it against the possible risks to the fetus. The doctors don't have the information to give clear advice, but can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct case classification and to limit the chance of bias.
However, the study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to medication use or if they were affected by co-morbidities. The researchers did not examine the long-term effects for the offspring.
The study did show that infants whose mothers took adhd and anxiety medication medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system disorders, and the higher risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child from continued treatment for the woman's condition. Physicians should speak with their patients about this issue and, if possible, help them improve coping skills which can lessen the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to continue or discontinue treatment during pregnancy is a question that more and more doctors have to face. These decisions are frequently made without clear and authoritative evidence. Instead, doctors have to take into account their own experience, the experience of other doctors and the research on the subject.
The issue of risk to the infant can be particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies, and a lot of the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link and the majority of studies show a neutral or even slightly negative impact. In each case an in-depth study of the benefits and risks is required.
For a lot of women with ADHD and ADD, the decision to stop taking medication is difficult if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for these patients. Furthermore, a loss of medication can affect the ability to do job-related tasks and drive safely, which are important aspects of daily life for many people suffering from ADHD.
She recommends women who are uncertain about whether to keep or stop medication in light of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily life, and the benefits of keeping the current treatment plan. In addition, educating them can make the woman feel more comfortable when she is struggling with her decision. Some what medications are prescribed for adhd can pass through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it's important to be aware that the medication could be transferred to the infant.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two massive data sets to examine over 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was linked to a slightly higher rate of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study found no link between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies that have shown a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to need a caesarean, have a low Apgar after delivery, and had a baby that required breathing assistance at birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could have contributed to the findings.
Researchers hope that their study will help doctors when they meet pregnant women. They recommend that, while the discussion of risks and benefits is important but the decision to stop or continue treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it isn't an option to consider due to the high prevalence of depression and other mental health problems for women who are expecting or postpartum. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them after the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. The rate of medication exposure will vary based on the dosage and frequency of administration as well as time of day. Additionally, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn is not completely comprehended.
Due to the absence of research, some physicians may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the potential dangers to the foetus. Until more information becomes available, GPs may inquire about pregnant patients if they have a history of ADHD or if they are planning to take medication in the perinatal stage.
Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do so. They have discovered through consultation with their physicians that the benefits of keeping their current medication far outweigh any possible risks.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counselling should include discussion of a management plan for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.
The decision to stop or keep ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There are few data regarding how exposure over time may affect a fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication for adhd and anxiety must weigh the benefits of taking it against the possible risks to the fetus. The doctors don't have the information to give clear advice, but can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to compare the incidence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct case classification and to limit the chance of bias.
However, the study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to establish whether the few associations observed between the groups that were exposed to medication use or if they were affected by co-morbidities. The researchers did not examine the long-term effects for the offspring.
The study did show that infants whose mothers took adhd and anxiety medication medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system disorders, and the higher risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.
The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child from continued treatment for the woman's condition. Physicians should speak with their patients about this issue and, if possible, help them improve coping skills which can lessen the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to continue or discontinue treatment during pregnancy is a question that more and more doctors have to face. These decisions are frequently made without clear and authoritative evidence. Instead, doctors have to take into account their own experience, the experience of other doctors and the research on the subject.
The issue of risk to the infant can be particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies, and a lot of the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link and the majority of studies show a neutral or even slightly negative impact. In each case an in-depth study of the benefits and risks is required.
For a lot of women with ADHD and ADD, the decision to stop taking medication is difficult if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation, and family conflict for these patients. Furthermore, a loss of medication can affect the ability to do job-related tasks and drive safely, which are important aspects of daily life for many people suffering from ADHD.
She recommends women who are uncertain about whether to keep or stop medication in light of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily life, and the benefits of keeping the current treatment plan. In addition, educating them can make the woman feel more comfortable when she is struggling with her decision. Some what medications are prescribed for adhd can pass through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it's important to be aware that the medication could be transferred to the infant.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two massive data sets to examine over 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was linked to a slightly higher rate of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study found no link between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies that have shown a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to need a caesarean, have a low Apgar after delivery, and had a baby that required breathing assistance at birth. However the researchers of the study were unable to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could have contributed to the findings.
Researchers hope that their study will help doctors when they meet pregnant women. They recommend that, while the discussion of risks and benefits is important but the decision to stop or continue treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also caution that while discontinuing the medications is an option, it isn't an option to consider due to the high prevalence of depression and other mental health problems for women who are expecting or postpartum. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them after the baby's arrival.
Nursing
The responsibilities of a new mom can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. The rate of medication exposure will vary based on the dosage and frequency of administration as well as time of day. Additionally, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn is not completely comprehended.
Due to the absence of research, some physicians may be inclined to discontinue stimulant medication during the course of pregnancy. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the potential dangers to the foetus. Until more information becomes available, GPs may inquire about pregnant patients if they have a history of ADHD or if they are planning to take medication in the perinatal stage.Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do so. They have discovered through consultation with their physicians that the benefits of keeping their current medication far outweigh any possible risks.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counselling should include discussion of a management plan for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.
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